Cancer changes the lives of millions of people. While those affected by cancer understand its impact, most people do not understand how significantly a cancer diagnosis can disrupt and, ultimately, take a person’s life. Cancer is “a group of diseases characterized by uncontrolled growth and spread of abnormal cells.” Cancer strikes across the population; it afflicts people of all ages, gender, race, ethnicity, religion, residence and socioeconomic status. It is estimated over 1.6 million new cancer cases were diagnosed in the United States 2012. Regardless of the specific type of cancer one has, a cancer diagnosis can be devastating to the patient, as well as their family and friends.
In addition to the obvious physical and emotional hardships, a cancer diagnosis can cause many to suffer financial hardship. Typically, those with more deadly forms of and late-stage cancer suffer more substantially from the financial challenges that a company cancer diagnosis. In one study, researchers found 7.7% of those diagnosed with lung cancer (the deadliest form of cancer) filed for bankruptcy within five years of being diagnosed. These financial challenges arise from a number of different sources. First, the cost of treating the cancer can be overwhelming, notwithstanding the patient’s access to health insurance. A recent study from Duke University Medical Center and Dana-Farber Cancer Institute found out-of-pocket cancer-related costs averaged $ 712 per month, despite all but one survey participant having health insurance and 83% of survey participants having prescription-drug coverage. Such costs can include insurance co-pays and non-covered treatments and medications. Second, and perhaps more financially impactful, is the loss of income associated with the patient’s and potentially the caregiver’s inability to continue working full time. The physical strains on late-stage cancer patients often prevent a patient from remaining employed and can even require the caregiver (often a spouse, sibling or adult child) to forgo or limit employment, compounding the higher cost of living with cancer with a significant reduction in household income. Finally, late-stage cancer patients often seek palliative care, whether in-home or in a hospice, which can be costly if not covered by Medicare or other insurance carriers.
While there is an incredible amount of data, information and resources devoted to informing and financial assistance for cancer patients, very little of it is designed to help late-stage cancer patients meet their overwhelming financial needs. Instead, a great deal of what is available attempts to reduce the incidence of cancer by focusing on research, awareness, prevention and early detection of cancer.In addition, resources for helping those diagnosed with cancer offer assistance with topics such as navigating the health care system, transportation, education and support groups. There are very few
American Cancer Society, Cancer Facts & Figures 2012. Atlanta: American Cancer Society; 2012.Id Staging describes the extent or spread of the cancer, ranging from State I (least) to Stage IV (most). For purposes of this article, we use the term “late-stage” to refer to Stage III and Stage IV.
The Wall Street Journal, Health Blog, Study Illuminates Link Between Cancer, Bankruptcy, available at http://blogs.wsj.com/bankruptcy/2011/06/07/study-illuminates-link-between-cancer-bankruptcy/?mod=google_news_blog (last visited December 4, 2012).
The National Institutes of Health estimates direct medical costs of cancer in 2007 were $ 103.8 billion and will reach $ 158 billion in 2020. The Wall Street Journal, Health Blog, Out-of-Pocket Costs for Some Cancer Patients Top $ 700 Monthly, available athttp://blogs.wsj.com/health/2011/06/06/out-of-pocket-costs-for-some-cancer-patients-top-700-monthly (last visited December 4, 2012).resources available to assist late-stage cancer patients in meeting their growing financial needs and their options are not generally well known or understood.
The most likely place for late-stage cancer patients to turn to meet financial needs is current assets. Obviously, patients have the most control and easiest access to their own assets. Unfortunately, given the American economy over the past four years, fewer people have meaningful “rainy day” funds to allow them to use current savings to fund cancer treatment and other daily living expenses. To the extent patients have savings available, often their savings is quickly depleted and is often difficult to replenish. Another asset that may be helpful can be a cancer patient’s home. For many homeowners, it can be a source of significant cash, but accessing this value can be time consuming and more difficult when a family’s income is reduced by the inability to continue earning at the same level as prior to the cancer diagnosis. Equity levels have dropped so precipitously with falling real estate prices and lending criteria have tightened so much, a home equity line or even a reverse mortgage is less viable as a source of funds for late-stage cancer patients.
Government assistance for cancer patients is limited. While there do not appear to be government assistance programs specifically for cancer patients, there are a number of federal and state programs that provide financial benefits that cancer patients may access, including Social Security, Medicare and Medicaid, the Department of Health & Human Services and the U.S. Administration on Aging. These benefits are typically entitlements and, therefore, do not require patients to use up current assets or take on future obligations. These programs, however,are typically set up for low-income households, the elderly and the disabled and many cancer patients may not qualify. Other government and nonprofit benefit programs have eligibility requirements that can limit a cancer patient’s access to potential benefits. Navigating the application and eligibility process for such assistance programs can be difficult, time consuming and frustrating, especially for those suffering physically from cancer. In addition, some individuals are unable to access these programs.
In addition, sources of financial aid such as non-profit grants and charitable grants generally provide assistance for specific expenditures (e.g., patient care, co-pay off-sets and prescription costs). Other programs limit the aid to defray the costs of transportation or the costs of treatment outside the home. These resources and the government assistance programs generally do not provide discretionary funds to help with day-to-day living expenses, such as mortgage payments, child care and other necessary expenses not tied directly to the cost of treating cancer. Therefore, other financial solutions are necessary.
For those late-stage cancer patients with a